Month: May 2013

The appendix gets a lot of bad press. We often think of it as one of the most pointless parts of our body that lacks any real purpose or function. But this may actually be far from the truth, with eye-opening research pointing towards an important role for this organ.

The appendix is a small, worm-shaped structure
located on the lower right side of the abdomen, connected to the cecum. Many of us are naïve about what it does, and often the only time that we hear about the appendix is when it becomes infected. When infection occurs we remove it without much second thought. Unlike the majority of organs in the body, little is known or understood about this mysterious organ.

Often we think of the appendix as simply an evolutionary remnant from times gone by, much like the coccyx found in humans (what remains from ancient tails or vestigial hind limbs in snakes, a reminder of past legs). Scientists as early as Darwin have theorised about its purpose, and come to the conclusion that it is an archaic organ, which became useless millions of years ago. This theory proposes that long ago the appendix was important for digesting very tough food such as leaves and tree-bark, but as human diets began to transform, so did the appendix. As humans began to eat more fruit and less vegetation that was hard to digest, the appendix began to shrink into what we recognise today. Some have even gone so far as to say that in the future the appendix will disappear entirely as it becomes redundant.

Although this explanation seems plausible, it seems naïve of us to assume that the appendix has no purpose. Why would an organ that supposedly has been redundant for so long remain in our bodies? Bill Parker from the medical centre in Durham, North Carolina has suggested a rather radical U-turn for the role of the appendix.

Parker suggested that the appendix could be useful to the ‘good’ bacteria in our gut, ensuring the smooth running of our digestive system. We know that our bodies are made up of trillions of cells, but actually houses around 10 times that number of micro-organisms, most of which are found in our guts. We have a symbiotic relationship with these organisms; they use our energy by digesting our food, and in return these ‘good’ bacteria help to prevent the spread of harmful bacteria and this is vital to the health of our gut.

According to Parker, the appendix may be vital in protecting our intestines ‘good’ bacteria from the ‘bad’ bacteria that try to invade our gut. Essentially, you could think of the appendix as a sanctuary or a weekend spa retreat for our vital microbes. These tiny bacteria can use the appendix as an area of respite from the strain of the harsh environment in the gut. When the stores of bacteria in the gut become depleted, bacteria can be released from the appendix to fill their place.

Although this theory is interesting, there has been little in the way of supporting evidence. One study led by James Grendall at the Winthrop University Hospital in America agrees with Parker’s theory. This study involved 254 patients each of whom had a history of gut infections caused by Clostridium difficile, and had been on antibiotics as a result. Patients that remain on antibiotics for a prolonged period of time can suffer from depletion in the ‘good’ bacteria in their gut, making it harder to fight off the bad guys.

Based on Parker’s theory, those individuals with an appendix should have a better chance at fighting off the infection by producing and sending more of the ‘good’ bacteria into the gut. However, those who have had their appendix removed may be unable to release these protective bacteria to replenish the stock in the gut, and therefore the ‘bad’ bacteria can take over.

What they found was striking. Out of the 254 patients, those without an appendix and consequently the bacteria housed there, were twice as likely to have a recurrence of the infection. Recurrence was likely to occur in 45% of cases when there was no appendix, compared to 18% recurrence in individuals who did have one.

We also know that the lining of the appendix is rich in infection-fighting lymphoid cells that accumulate shortly after birth, peaking in our 20’s and 30’s but rapidly decreasing as we age. This lymphatic tissue encourages the growth of beneficial gut bacteria.

Although it is tempting to believe that our appendix is a redundant vestigial organ, there is the possibility that it plays a role in protecting the ‘good’ bacteria in our gut. There is however little in the way of research to confirm its role one way or another. I think for now the exact role of the appendix will remain a mystery, at least until more research is carried out.

I am what is known in the research trade as a ‘basic’ researcher. It’s not that my work is simple. What basic research means is that the work doesn’t have any immediate real world application.

In some people’s eyes that means it’s not useful, or ‘research for the sake of research’. In my opinion it’s pretty exciting – I look at how and more importantly why things move around inside cells. Intrigued? Read about it here.

These scientists might be doing basic research, just don’t ask what’s in the tube.

Some research has direct applications – researching new drugs, new technology, the effect of various factors on health and the environment, you know – ‘useful stuff’. The thing about all of that research is that it has its foundations deeply rooted in knowledge gained from basic research.

Now don’t get me wrong I like the stuff that comes out of ‘useful’ research. I’m keen to find out how many rashers of bacon I can chow down on before I’ll get cancer. If I get ill I’d definitely want a new drug that could treat me. I’m eager to find out how much we’re screwing up the planet. Research that translates to the real world is awesome. I just think basic research should get more credit, or at least less flack, for contributing to science and our understanding of how things work.

Most importantly, basic research deserves to get funding. Not just because it’s interesting, but because we don’t know what useful things may come out of it one day in the future. If BuzzFeed has taught me anything, it’s that a point is always made best in the form of a list. So here are my ‘Top 3 Basic Research to Real World Breakthroughs ’. Catchy name, no?

1. The Structure of DNA

Raging misogyny and racism aside, if Watson and Crick hadn’t taken Roselyn Franklin’s data without her permission* and worked out the structure of DNA…well someone would have probably worked it out eventually. But that doesn’t take away from their combined genius in solving the structure. They also did ground breaking work to discover how genes in DNA are made into protein. Intellectually speaking they were/are pure brilliance.

Now, this may all seem applicable to the real world in the first instance but when you think about it, Watson and Crick wanted to know the structure of DNA and how it worked purely for the knowledge. When they made this humanity-changing intellectual breakthrough, they had no idea that one day our knowledge of DNA would lead to huge leaps forward in medical diagnosis and treatment, or for that matter the ‘Who’s the daddy?’ paternity tests of Jeremy Kyle. The latter is more important. Obviously.

2. The discovery of cellulose.

Cellulose; everyone’s favourite plant based, un-digestible polysaccharide. I’d guess when Anselme Payen discovered this polymer in 1838 he was just really psyched to find out more about the molecules in plants. I’d certainly be surprised if he envisioned that one day cellulose would pave the way for polymer science and one of our greatest inventions – plastic. Don’t think plastic is terrific? Look around you– how much stuff is made out of plastic? Plastic has made manufacturing easy. The discovery of cellulose as a natural polymer aided polymer research in years to come, most notably the Nobel Prize winning work of Hermann Staudinger. In turn, understanding polymers provided a means to produce many different and useful types of plastic that we can use to make stuff cheaply and easily.

3. Radioactivity

Marie Curie. She was one seriously cool lady. Alongside her also very cool husband, Pierre, she discovered radioactivity. After years of toil they purified and discovered polonium and radium. The research was unquestionably driven by the desire to simply understand what radioactivity was. The work has been instrumental in helping us understand basic physics at an atomic and sub-atomic level. Despite this, the research Marie and Pierre did has given rise to many real world changes including nuclear energy, medical treatments such as radiotherapy to treat cancer, alongside uses in sterilisation of food and other fields of research.

So there you have it, my ‘Top 3 Basic Research to Real World Breakthroughs ’. But there have been way more. What have I missed out? What would go on your list? Let us know in the comments below.

Post by: Liz Granger

Twitter: @Bio_Fluff

*This is only one side of the story. Read more about the dynamic between Rosalind Franklin, her colleagues and Watson and Crick, here and here.

What do acne and chronic back pain have in common? Well, as it turns out, more than people once thought. A group at the University of Southern Denmark have found that the same bacteria that gives people spots might be to blame for up to 40% of patients with lower back pain. What’s more, these infections can be treated with antibiotics.

Slipped disc popping out from in between the evenly grey vertebrae

Your backbone is a column of alternating vertebrae (bones) and intervertebral discs (cushions). The bones provide the strength and support, while the cushion discs allow movement and flexibility. Occasionally, thanks to a mix of age and awkward movement, the disc can bulge out from between the bones. In some cases the jelly-like goo in the disc’s centre, called the nucleus, can even ooze out – a bit like thick jam leaking out of a doughnut. If the nuclear material or the disc itself puts pressure on nerves coming in and out of the spine, it can be even more painful.

Slipping a disc is, by all accounts, excruciating, but it usually starts to heal by 6-8 weeks. However, someone can be diagnosed with chronic back pain (CBP) when the pain doesn’t subside after three months. Trouble is, this happens all too often, with an estimated 4 million people in the UK suffering from CBP at some point in their lives. The cost of CBP to the NHS is about £1 billion per annum. This doesn’t even cover lost working hours or the loss of livelihood suffered. Treatment usually focuses on relieving pain, preventing inflammation and more recently, cognitive behavioural therapy to treat the patient’s psychology, especially if the organic, physical cause of the pain is no longer obvious.

Recently, scientists in Denmark found a really important link between the bacteria responsible for acne, known as Propionibacterium acnes (P. acnes) and bad backs. The researchers found that in about half of their patients with slipped discs, the disc itself was infected, usually with P. acnes. A year later, 80% of the infected patients – compared to 43% of the uninfected patients – had dodgier bones either side of the slipped disc than 12 months before. The affected bones had developed tiny fractures and the bone marrow was replaced with serum, the liquid found in blisters.

Acne is not to blame for bad teenage hairstyle choices.

So how did the discs get infected? Bacteria like P. acnes get into our bloodstream all the time, particularly when we brush our teeth or squeeze spots. P. acnes and other similar bacteria don’t like oxygen-rich environments and so don’t normally grow inside us. The spinal disc doesn’t have a lot of oxygen around, providing a perfect home for the bacteria. If the disc is damaged – say, after popping out from the spinal column – tiny blood vessels sprout into it, letting the bacteria move in and settle down.

There, the bacteria grow and, rather than spread anywhere else, they spit out inflammatory chemicals and acid. The acid corrodes the bone next to the disc and causes more swelling and pain around the area. This discovery is ground-breaking, since before this research it was thought that discs couldn’t get infected except in a few exceptional cases.

The Danish researchers then conducted a second study, testing whether simple antibiotics could get rid of these bacteria and therefore treat chronic lower back pain. Patients that already had the characteristic signs of bone inflammation (tiny fractures and swelling) were given a 100-day course of antibiotics. The patients were reassessed a year after the trial began. Patients treated with antibiotics reported less pain, less ‘bothersomeness’ (yes!), took fewer days off work, made fewer visits to the doctor and, crucially, their bones looked in much better nick than the patients given a placebo.

Considering the huge numbers of people who are affected by chronic back pain, and the cost of treatments like surgery versus a course of antibiotics, this discovery has been glorified as the stuff of Nobel prizes. The revelation that bacteria may be to blame for some cases of this mysteriously untreatable condition rings familiar. It has been likened to the discovery of the culprit bacteria behind stomach-ulcers, Helicobacter pylori. Like back pain today, stomach ulcers were dismissed for years to be a disease of the mind, endemic among stressed-out melodramatics or people who ate too much spicy food. (And yes, Barry Marshall did get a Nobel Prize for swallowing a Petri-dishful of H. pylori.) It would be fantastic if, instead of resorting to surgery, half a million CBP patients could be effectively cured within 100 days or less!

The bacteria in the plate on the right have become resistant to many of the antibiotic white spots and so are more widespread.Photo by Dr. Graham Beards

Unfortunately, there is a downside. Antibiotics have long been the magical cure-all, but just like fossil fuels, housing and talent on TV, we’re running out. Bacteria are becoming resistant to antibiotics faster than we can create new, effective ones. It’s an arms race and we’re losing, very quickly. What’s worse is that because of the recent negativity surrounding over-prescription, there are now restrictions on giving patients broad spectrum antibiotics. Since antibiotics can’t be used as much as they were 30 years ago, pharmaceutical companies can’t make any profit from developing new ones. And so, to further compound the problem of antibiotic resistance, there are fewer and fewer antibiotics being created every year.

In 2000 alone, UK doctors made 2.6 million prescriptions of antibiotics for acne. One study by a group in Leeds looked at the number of acne patients who were infected with P.acnes and were resistant to at least one type of anti-acne antibiotic. Between 1991 and 2000, the fraction of acne patients with antibiotic-resistant bacteria rose from about a third to more than a half.

The discovery that acne bacteria might be to blame for so many cases of debilitating back pain is hugely important. However, it also highlights how dependent we are on our dangerously dwindling supply of effective antibiotics, and how we might be wasting antibiotic effectiveness on comparatively trivial conditions such as spots.

Exam time is fast approaching and once again this year pupils will not only be fretting about their potential grades, but also over the following inevitable barrage of claims concerning falling exam standards. Yes, however hard you may have worked for that A* to C grade, according to the tabloids, your efforts were futile. Particularly since modern GCSEs are now little more than the academic equivalent of an award for ‘taking part’ – spell your name correctly and walk home with a qualification. But we all know that this is not really the case, that the real situation is significantly more complex.

The truth is, contrary to what we hear from politicians, comparison of exam standards is not an exact science. A seminar held in 2010 by the examinations group Cambridge Assessment concluded that “it is not possible to compare standards, definitively, over long periods of time and perhaps attempting to do so is simply confounding the problem.” Professor Gordon Stobart, from the Institute of Education compared the debate over exam standards with climbing Mount Everest noting that: “In 1953 two people got to the top of Everest, an extraordinary achievement at the time. Yet on a single day in 1996, 39 people stood on the summit.” Does this mean that the mountain is getting easier to climb? Not necessarily, it may simply reflect the fact that more people are attempting the climb and that those who do so are now better equipped.

I took my GCSEs around 12 years ago and still remember feeling my success was tempered by claims that exams were ‘getting easier’. I can certainly vouch for the fact that they didn’t feel easy! But, then again, I had nothing to compare them to since, at that time, they were the hardest exams I’d ever taken. Interestingly, the small amount of research which exists in this area shows modern GCSEs are not equivalent to their predecessors the O-levels. A study by the Royal Society of Chemistry (the Five Decade Challenge) found that current students had a harder time answering exam questions taken from the old O-level syllabus than questions written after the GCSE switch-over. The scores for all GCSE-style questions, irrespective of date, remained relatively stable. The study found that students performed well on tests of recall but found problem-solving and tests of quantitative skill challenging.

There are many explanations for these and similar results. It is possible that exams are getting easier. However, it’s equally possible that changes to the syllabus and style of question mean that modern students show different strengths than those required to answer O-level style questions.

Anecdotal accounts argue that a culture of ‘teaching to the test’ means that modern students are encouraged to play the system, favouring lessons on exam technique over studying all available material. A particularly worrying example of this can be seen here. To be honest, I do remember a lot of emphasis being placed on past paper learning, knowing how to answer questions and rote learning of facts and figures – something I’m actually pretty terrible at. Add to this a survey by the Confederation of British Industry showing that “more than four out of 10 employers are unhappy with youngsters’ use of English, while 35% bemoan their numeracy skills” and the notion that lecturers often complain about students’ lack of initiative, a worrying picture starts to emerge.

Wherever the problems lie, I believe that it is unfair to blame the students for these failings. Constantly reminding them that the exams they agonised over for the last few years were ‘easy’ won’t solve anything and at worst could be damaging. I also doubt teachers are at fault; they are instead victims of a culture that craves an end result without caring how it is achieved. Instead, we need to take a long hard look at the current system itself and decide whether or not it is still fit for purpose. Luckily this is exactly what education secretary Michael Gove is doing right now. In a recent letter to Ofqual he argues that that “there is an urgent need for reform, to ensure that young people have access to qualifications that set expectations that match and exceed those in the highest performing jurisdictions.”

He is embarking on a mammoth task, which I certainly don’t envy. Not least when it comes to science education. With public debate ranging from GM crops to vaccinations, scientific understanding is a must in today’s society. Especially since it has been argued that individuals without a working appreciation of science are more likely to be swayed by pseudo-science and unfounded propaganda. Therefore, providing our children with a strong working understanding of basic science is a must.

Unfortunately I worry that Mr Gove’s reforms run the risk of ‘missing the mark’ when it comes to science. They appear to concentrate heavily on standardising the format of secondary school teaching, removing emphasis on coursework and ensuring qualifications are “linear, with all assessments taken at the end of the course.” This may indeed provide “qualifications that set expectations that match and exceed those in the highest performing jurisdictions.” However, I worry it will fail to tackle the true failings in our current science curriculum.

The Science and Technology Committee Report of Science Education – 2002 states that: “the current curriculum aims to engage all students with science as a preparation for life. At the same time it aims to inspire and prepare some pupils to continue with science post-16. In practice it does neither of these well.” Even more damning is the report’s observations on course structure. It states that “practical work, including fieldwork, is a vital part of science education. It helps students to develop their understanding of science, appreciate that science is based on evidence and acquire hands-on skills that are essential if students are to progress in science.” However, it recognises that due to pressures and time constraints placed on teachers, coursework now has “little educational value and has turned practical work into a tedious and dull activity for both students and teachers.” From this they conclude that “many students lose any feelings of enthusiasm that they once had for science… neither enjoy or engage with the subject… they develop a negative image of science which may last for life.” And I can’t see this situation improving if reform means more emphasis on achievement in a final exam and less emphasis on continuous coursework assessments.

The proposed system may place more pressure on teachers to maintain standards through exam achievement alone, running the risk of exacerbating our ‘teach to the test’ culture and marginalising the significance of practical skills development. I hope that if these changes are thoughtfully implemented such problems may be avoided. However, the outcome of this still remains to be seen.

I wonder if there is scope for the scientific community to become further involved in secondary school science education. Successful projects such as I’m a Scientist Get me Out of Here are already gaining in popularity. But, there is still much more we can do. For example: developing online e-learning resources covering the basic curriculum whilst also enabling active scientists, working in related fields, to communicate with students through blogs and forums – placing the curriculum on the context of real-world research. I know scientists are concerned about how their subjects are taught, so perhaps it’s a good time to start building better links with schools and really getting involved?